Register for Classes – Sierra Nevada Ballet

Today's Date *

First Name *

Last Name *

Parent's Name (if under 18 years old)

Birthdate *

Gender *FemaleMale

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal code *

Country *

Home Number *

Cell Number *

Work Number

Email Address *

How Did You Hear About Us *WebsearchPerformancePosterWord of Mouth

Emergency Contact *

Emergency Contact Phone Number *

Medical Conditions (if any such as asthma, allergies, etc. If none, enter "none") *

We will occasionally use pictures of our dancers in various studio promotional materials, including our website. Please check below with your consent for the possible use of your child's image. *I agree

Dance is a physical activity. I agree to not hold Sierra Nevada Ballet's representatives and/or teachers liable for any claims or injury arising out of or relating to their program. I have read and understand all the terms and conditions above. *I agree

Class(es): *

Day(s) of the Week: *

Total Number of Classes/Week: *